UW-DFM Clinical Data Warehouse Helps Track Influenza

Forward By Alice Erickson, MS (Data Warehouse Technical Project Leader)

Transparency is the goal of all IT (Information Technology) work. IT staffers are the people behind the scenes ensuring your data stays safe, your mail programs work, your files can be shared securely and that the many other available processes and resources operate smoothly. The Clinical Data Warehouse is no exception.

Data upload and reporting programs - developed by the Data Warehouse Team - access University of Wisconsin Medical Foundation Epic data nightly and bring it into our local Department of Family Medicine database. Additionally these programs validate and massage the data into easily utilizable Department of Family Medicine information. The tens of thousands of lines of code that underlie the warehouse programs and database structure are invisible to our customers. The end result is a Department of Family Medicine Warehouse, which includes 300,000+ visits per year from a patient basis of over 30 clinics. As clinics come on line with EpicCare (the new electronic medical record system), additional data such as lab results will be available for use.

Department of Family Medicine Warehouse data is available to meet your needs upon request, through an easy ad-hoc request form found at: https://cdw.fammed.wisc.edu/. The warehouse also provides automated reporting to a variety of users on a weekly, monthly, quarterly and yearly basis.

The following article by Jon Temte, MD, PhD is an example of how one such weekly data report is put to use.

An automated data stream from the University Of Wisconsin Department of Family Medicine Clinical Data Warehouse is used to help in the evaluation of influenza trends in Wisconsin. Each week, data on the total number of patients seen in the Family Medicine clinics and those patients assigned at least one acute respiratory infection diagnosis are automatically pulled. The data are used to calculate the percentage of Family Medicine patients presenting with an acute respiratory illnesses (ARIs).

The system started in mid-November and has been perking along ever since. Over the last four months, ARIs (Acute Respiratory Illness) have affected between from 12.1% to 19.7% of our patients on a weekly basis, with a mean of 14.7%. This compares to an average of 3.1% of our patients suffering from an influenza-like illness.

When this information is further examined and coupled with data flowing from other influenza surveillance systems, some interesting things crop up. For example, if one concentrates on the percent of ARIs that meet criteria for an influenza-like illness (ILI)-that is: patients with a fever over 100°F and a cough or a sore throat-and further couples that information with virus culture data, the effects of specific viruses in our patient population can be assessed.

Throughout Wisconsin, parainfluenza viruses dominated the scene in November while influenza was absent. During this period, about a third of ARIs were blessed with fever, and a cough or sore throat. As influenza has crept into Wisconsin, rather late this year, there has been a corresponding increase of ILI symptoms in our patients with acute respiratory illnesses.

For any Department of Family Medicine Data Warehouse questions, please contact warehouse@fammed.wisc.edu.